He promised that within the next one hundred days, his government will eliminate all charges on maternity care in public health facilities.

While many are busy examining the financial implications of this promise, and perhaps making conclusions on its feasibility, I would whole-heartedly endorse it as the beginning of better healthcare for all Kenyans.

Indeed, increasing the proportion of deliveries assisted by skilled attendants in hospitals has many benefits. Firstly, the money that would have been spent on deliveries can be put to other use by the family, such a buying food and clothing or paying for education and accommodation.

Secondly, this move will ensure that babies are born in safe environments, reducing the risk of complications and ensuring that they get all requisite immunisations and treatment early in life. Their mothers are also more likely to get educated on better childcare techniques, improving the health of their offspring.

The resulting good health will inoculate children against malnutrition and diseases, and give them a healthy start in life. This will improve their chances of succeeding in academics, sports and any other areas they choose to participate in. The benefits to society would be incalculable when we have a large pool of highly motivated, healthy youth ready to put their ideas into practice.

But there are a few bottlenecks that will threaten the president’s declaration, right from inception. Firstly, all healthcare services at the county level are meant to be under the county governments. The role of the national government in health is limited to supra-county functions such as national referral health facilities, disaster management, and health policy.

Before rolling out the free maternity care services, it will be prudent for the national government to constructively engage the county governments to work out modalities of its implementation. Ad hoc implementation will result in a chaotic situation where counties allied to the national executive do one thing, while others do another. The loser will be the ordinary Kenyan.

Secondly, free health services of any shade require investment in infrastructure, human resources and consumables. In order to implement this promise, the government will have to develop a plan to improve the existing infrastructure, train and recruit a qualified health workforce, and ensure consistent supply of medications and other supplies.

Finally, maternity services cannot be offered in isolation. The incoming government needs to develop a comprehensive health policy that will ensure that all common causes of morbidity and mortality are addressed. One would expect that these plagues would also come under the “free service” ambit, in order to more comprehensively improve the health of Kenyans.

If the government increases health expenditure to at least 15 per cent of the budget as set out in the Abuja Declaration, we shall be able to offer not only free maternity services, but also free child health, mental health and public health interventions.

This can be accomplished within the next five years, if the government is prepared to back its promises with political goodwill and financial support. Hopefully the president will demonstrate this when he addresses Parliament on Tuesday.

Dr Lukoye Atwoli is the secretary, Kenya Psychiatric Association and a senior lecturer at Moi University’s School of Medicine lukoye@gmail.com; Twitter @LukoyeAtwoli

But fears that he could end up suffering from depression from watching patients die from easily treatable diseases because of lack of equipment are making him hold back.

As a student at Starehe Boys Centre in the 1990s, Dr Wambulwa was delighted when the school, through its career development programme, found him an attachment as a volunteer at Kenyatta National Hospital.

“At the end of the attachment, I changed my mind after seeing patients not being attended to for what my mentoring doctor said was lack of equipment,” he recalls.

The worst case involved a patient in his 40s who lay on the floor for three days while dehydrated. “When I asked why, the doctor said the hospital did not have enough beds,” Dr Wambulwa said.

“Seeing patients suffer needlessly made me swear I would never be a doctor,” he said.

But destiny came calling years later after he moved to the United States and completed a degree in Liberal Arts. He enrolled at Howard University College of Medicine.

Today, Dr Wambulwa works for a month every year at a public hospital in Kenya. He says conditions have improved but the situation is still dire.

“I once worked at a hospital where babies shared beds,” he said. “This is unacceptable in health, worse still at a referral facility.”

In such cases, Dr Wambulwa said, a baby can be treated but then leaves the hospital with another disease.

Dr Wambulwa has worked at KNH, Moi Referral Hospital in Eldoret, Kitale General Hospital and Kakamega Provincial General Hospital.

His story may sound exaggerated but it underlines the problems local hospitals face which the government of President Uhuru Kenyatta face.

The Jubilee manifesto, which the new government started implementing this week by ordering free maternity health care, agrees with Dr Wambulwa’s statement that easily preventable diseases like malaria, tuberculosis and HIV/Aids claim too many lives each year, largely because hospitals are ill-equipped.

“Hospital services must improve, with better pay and conditions for healthcare professionals and a higher standard of care and treatment for patients being central to our health sector reform agenda,” the manifesto says.

So bad is the situation of inadequate facilities that Dr Daniel Ondiek, who graduated from the University of Nairobi, quit for aviation after just three years on the job.

Avoidable deaths

“When you lack very basic equipment, you end up counting avoidable deaths; you end up living with a heavy heart that someone died of an avoidable cause,” he says.

Dr Ondiek also says poor salaries were driving medics to other countries or in his case, other professions.

The entry salary for a pilot is Sh400,000 while a medical intern starts with a measly Sh45,000.